4 research outputs found
Reducing the Clinical and Public Health Burden of Familial Hypercholesterolemia A Global Call to Action
Q1Q1Artículo completoE1-E13IMPORTANCE Familial hypercholesterolemia (FH) is an underdiagnosed and undertreated
genetic disorder that leads to premature morbidity and mortality due to atherosclerotic
cardiovascular disease. Familial hypercholesterolemia affects 1 in 200 to 250 people around
the world of every race and ethnicity. The lack of general awareness of FH among the public
and medical community has resulted in only 10% of the FH population being diagnosed and
adequately treated. The World Health Organization recognized FH as a public health priority
in 1998 during a consultation meeting in Geneva, Switzerland. The World Health Organization
report highlighted 11 recommendations to address FH worldwide, from diagnosis and
treatment to family screening and education. Research since the 1998 report has increased
understanding and awareness of FH, particularly in specialty areas, such as cardiology and
lipidology. However, in the past 20 years, there has been little progress in implementing the
11 recommendations to prevent premature atherosclerotic cardiovascular disease in an entire
generation of families with FH.
OBSERVATIONS In 2018, the Familial Hypercholesterolemia Foundation and the World Heart
Federation convened the international FH community to update the 11 recommendations.
Two meetings were held: one at the 2018 FH Foundation Global Summit and the other during
the 2018 World Congress of Cardiology and Cardiovascular Health. Each meeting served as
a platform for the FH community to examine the original recommendations, assess the gaps,
and provide commentary on the revised recommendations. The Global Call to Action on
Familial Hypercholesterolemia thus represents individuals with FH, advocacy leaders,
scientific experts, policy makers, and the original authors of the 1998 World Health
Organization report. Attendees from 40 countries brought perspectives on FH from low-,
middle-, and high-income regions. Tables listing country-specific government support for
FH care, existing country-specific and international FH scientific statements and guidelines,
country-specific and international FH registries, and known FH advocacy organizations
around the world were created.
CONCLUSIONS AND RELEVANCE By adopting the 9 updated public policy recommendations
created for this document, covering awareness; advocacy; screening, testing, and diagnosis;
treatment; family-based care; registries; research; and cost and value, individual countries
have the opportunity to prevent atherosclerotic heart disease in their citizens carrying a gene
associated with FH and, likely, all those with severe hypercholesterolemia as well
The prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive patients.
Objectives: A growing body of data illustrates the importance of microalbuminuria (MAU) as a strong predictor of cardiovascular risk in the hypertensive population. The present study was designed to define the prevalence of MAU and associated cardiovascular risk factors among Turkish hypertensive outpatients. Study design: Representing the Turkish arm of the multinational i-SEARCH study involving 1,750 sites in 26 countries around the world, a total of 1,926 hypertensive patients from different centers were included in this observational and cross-sectional survey study. Patients with reasons for a false-positive MAU test were excluded. The prevalence of MAU was assessed using a dipstick test, and patients were inquired about comorbidities, comedication, and known cardiovascular risk factors. Results: The overall prevalence of MAU was 64.7% and there was no difference between genders. Most of the patients (82.5%) had uncontrolled hypertension, 35.6% had dyslipidemia, and 35.5% had diabetes, predominantly type 2. Almost one-third of the patients (26.4%) had at least one cardiovascular-related comorbidity, with 20.3% having documented coronary artery disease (CAD). Almost all patients (96.8%) had one or more risk factors for cardiovascular disease in addition to hypertension, including family history of myocardial infarction or CAD, diabetes, dyslipidemia, lack of physical exercise, and smoking. A trend towards higher MAU values in the presence of CAD was determined. Conclusion: Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients. © 2011 Turkish Society of Cardiology